[Intracerebral hematoma caused by rupture of intracranial angioma. Analysis, prognosis and clinical course of 35 comatose patients admitted to intensive care units].
The outcome of 35 patients in deep coma (GSS less than 7) due to an intracerebral hematoma following ruptured arteriovenous malformation (AVM) and admitted to a neurosurgical intensive care unit is reviewed. Eighty percent of these patients had a cerebral AVM and 20% had an AVM in the posterior fossa. All had a medical treatment of increase intracranial pressure (ICP). Twenty-four patients or 68.6% had an early surgical treatment or some days further and 13 had a good outcome, six had a persistent coma or a residual neurological deficit and five died. Four patients or 11.4% had an endovascular embolisation therapy and three had no satisfactory results and one died; all had a new intracranial hemorrhage with hematoma. Seven patients were not treated: four died before 48 hours of hospitalisation, one is in persistent coma and two are waiting an endovascular embolisation, alive but with a neurological deficit. The results suggest that neurosurgical treatment are a safe and effective means for treatment of these AVM with compressive intracranial hematoma.
Lamy
B
B
Département d'Anesthésie-Réanimation, Hôpital neurologique et neurochirurgical P. Wertheimer, Lyon.
Jourdan
C
C
Leclerc
R
R
Deschamps
J
J
Tixier
S
S
Convert
J
J
Artru
F
F
D000293:Adolescent; D000328:Adult; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000628:therapy; D002648:Child; D003128:Coma / Q000209:etiology*; D003422:Critical Care; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous
Hématome intra-cérébral par rupture d'angiome intracrânien. Analyse, pronostic et évolution à propos de 35 comateux admis en réanimation.